[View Printable Version]
EMPLOYEE BENEFITS SPECIALIST
DISTINGUISHING FEATURES OF THE CLASS
The work involves responsibility for assisting in the administration of the various employee benefit programs. The employee is responsible for determining benefit eligibility and explaining and interpreting benefit coverage to employees and retirees. An employee in this class works within the guidelines of the various mandates that govern benefit programs. May delegate routine duties to clerical personnel, but supervision of subordinate employees is not a function of this class. Does related work as required.
TYPICAL WORK ACTIVITIES
Interpret and analyze benefit plan documents, regulations and procedures to administer plans accordingly to all participants.
Determines eligibility for employee health, dental, prescription drug, vision, and long term disability programs.
Assists in the interpretation and implementation of rules and regulations for application to and enrollment in benefit programs such as New York State Retirement, COBRA, Family Medical Leave Act and the Affordable Care Act.
Responds to telephone and written inquiries from providers, employees, and plan administrators on eligibility criteria, benefit provisions, and claims handling and procedures.
Responds to correspondence and requests from county departments and outside agencies regarding benefits related issues.
Determines eligibility and subsequent enrollment in the various leave programs offered by the employer.
Processes leave of absence information, including letters of explanation, plan requirements, invoicing for appropriate premiums following negotiated contract settlements and federal leave policies.
Interprets and complies with various union agreements as they pertain to the benefit programs.
Maintains information on retirees and retirement programs and communicates such benefits to these members.
Meets with groups of employees and retirees to advise them on various benefit programs and procedure, including new employee orientation and annual open enrollment.
FULL PERFORMANCE KNOWLEDGES, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS
Good knowledge of rules, regulations and eligibility criteria of the employee benefits programs.
Good knowledge of the various federal, state, and local laws and mandates as they pertain to the employee benefit programs.
Good knowledge of health insurance rates, types of coverage, deductions, credits and billing procedures.
Good customer service skills and the ability to give information and relate well with people in person and over the telephone regarding benefit matters.
Good computer skills in order to maintain data necessary for the overall performance of benefit programs.
Ability to interpret written, narrative, and tabular material regarding benefit programs.
Two (2) years of permanent competitive class status as an Employee Benefits Claim Clerk or Employee Insurance Representative.
A. Graduation from a regionally accredited college or university or one accredited by the New York State Board of Regents to grant degrees with an Associate’s Degree and one (1)year of work experience, or its part-time equivalent, in administering an employee insurance benefits program or in reviewing and processing other health and/or medical insurance benefit program eligibility criteria; or,
B. Three (3) years of work experience, or its part-time equivalent, in administering an employee insurance benefit program or in reviewing and processing other health and/or medical insurance benefit program eligibility criteria.